Obesity & The Poverty Paradox

The Washington Post goes to Hidalgo County, Texas, one of the poorest counties in the nations — and one of the fattest. Excerpt:

The family checkup had been scheduled at the insistence of a school nurse, who wanted the Salas family to address two concerns: They were suffering from both a shortage of nutritious food and a diet of excess — paradoxical problems that have become increasingly interconnected in the United States, and especially in South Texas.

For almost a decade, Blanca had supported her five children by stretching $430 in monthly food stamp benefits, adding lard to thicken her refried beans and buying instant soup by the case at a nearby dollar store. She shopped for “quantity over quality,” she said, aiming to fill a grocery cart for $100 or less.

But the cheap foods she could afford on the standard government allotment of about $1.50 per meal also tended to be among the least nutritious — heavy in preservatives, fats, salt and refined sugar. Now Clarissa, her 13-year-old daughter, had a darkening ring around her neck that suggested early-onset diabetes from too much sugar. Now Antonio, 9, was sharing dosages of his mother’s cholesterol medication. Now Blanca herself was too sick to work, receiving disability payments at age 40 and testing her blood-sugar level twice each day to guard against the stroke doctors warned was forthcoming as a result of her diet.

Notice that this isn’t a matter of changing social stigma about obesity. This is a woman whose obesity makes her so unhealthy she cannot work, and whose life is in danger. More:

“El Futuro” is what some residents had begun calling the area, and here the future was unfolding in a cycle of cascading extremes:

Hidalgo County has one of the highest poverty rates in the nation . . . which has led almost 40 percent of residents to enroll in the food-stamp program . . . which means a widespread reliance on cheap, processed foods . . . which results in rates of diabetes and obesity that double the national average . . . which fuels the country’s highest per-capita spending on health care.

This is what El Futuro looks like in the Rio Grande Valley: The country’s hungriest region is also its most overweight, with 38.5 percent of the people obese. For one of the first times anywhere in the United States, children in South Texas have a projected life span that is a few years shorter than that of their parents.

It is a crisis at the heart of the Washington debate over food stamps, which now help support nearly 1 in 7 Americans. Has the massive growth of a government feeding program solved a problem, or created one? Is it enough for the government to help people buy food, or should it go further by also telling them what to eat?

Read the whole thing. It talks about how political efforts to restrict what families can spend food stamps on — a state representative from this area wanted to forbid families from spending food stamps on energy drinks — failed in the legislature, because most people, including both industry and anti-hunger groups, didn’t want to regulate what people ate. Educational efforts also have failed. It’s a complex problem of economics and culture. And a costly one on the health care front. And a deadly one.

Remember when Palin jumped all over Michelle Obama for planting an organic vegetable garden on the White House lawn, and telling kids not to eat dessert? Because embracing obesity, I suppose, is a conservative value. Gluttony and indulging in stupid, self-destructive food habits is a sign of your conservative bona fides. If Michelle Obama took up the cause of literacy, Palin would recommend watching more Honey Boo Boo.

“Come on.After our father died,my little brother & I used food stamps when we went grocery shopping.What does shame have to do with anything & what would that have accomplished?
Unless one’s a rabid libertarian,social programs that provide a safety net are OK.When they become a lifestyle or are abused, that’s a different proposition.”

That was supposed to be a bit tongue in cheek, but supposedly that was part of the reason to switch to the card-it didn’t have the visible stigma attached to the old “stamps”. Debit/credit cards do not have a particular “look”, per se, and can take about any decoration. The old food stamp took the form of a banknote (or stamp, depending on the era) but with their multicolored ink depending on the denomination, there was no confusing them for a greenback.

Not that one’s reason for using public assistance is necessarily bad but there are plenty of people who could use a little assistance in attitude adjustment. No one should enjoy having to make use of government handouts. If I absolutely had to I would, but I’d also be doing my damnedness to get off of them. Making it obvious that this is what I was doing would certainly help this process along.

If you read my previous entry, I said as much that such a “safety net” isn’t bad as long as its really assistance and not just dole-living. Problem is, its become a lot more about dole-living than assistance.

Josh,

“You don’t remember Sarah Palin and others brandishing their big gulps last year at photo ops and campaign stops? I believe Our Working Boy blogged about it last summer.”

I do believe that was in response to Mayor Bloomberg’s little attempt to outlaw such things in New York to cash paying customers. Its one thing to make poor beverage choices on your own dime, its another to make them on ours.

Faced with a limited budget Mom can either spend $13+ and get enough meat and vegetables to last 2 meals, or she can spend the same $13 and get enough food to last for over 3 meals.

Eating healthy is more expensive than eating cheap. Don’t get me started on Totinos Pizzas at $1.19 each, or Banquet pot pies at $0.89 each. Even Gortmans’ Breaded Fish at $4.79 for 10 pieces is cheaper than buying anything in the fresh meat aisle.

I truly have to wonder if any of the commenters here have ever tried to feed a family on food stamps/SNAP. If they had I am not certain they would be so flip about it.

Apparently. It really shouldn’t be that expensive to hire some dietitians to put together some healthy meals that are affordable on food stamps. Further, food stamp recipients should be limited in what they can buy, and the food on the suggested meal plans should be food allowable under food stamps. I think a key point would be to make the suggested meals as easy as possible to prepare and pretty taty.

The children (or at least the 9-year-old, maybe also the 4-year-od) of the family featured in the article Rod referenced probably qualify for free or reduced lunches, so the family does not need to use food stamp money for them.

OK, I’ll say it: you can get a lot more food for your family if your family doesn’t have five kids.
If you can’t control what you put into your mouth or womb, you’re never going to NOT be poor.
Period.

The “food desert” business may explain some of this, but I’d still have to be convinced that, if healthier food and fresh produce were more readily available in some poor neighborhoods, people would actually buy it and cook it. What you also need is a culture that values cooking. Frankly, a lot of middle-class people fall pretty flat on this one as well. Caitlin Flanagan nailed this one in one of her articles in which she pointed out that all these “rebuild your family” self-help books fetishize the act of sitting down to dinner as a family, without realizing what this actually entails. People actually have to be around to eat dinner, which means:
-Adults can’t work crazy amounts of overtime (pretty difficult in today’s workplace culture)
-Kids can’t engage in time-consuming extracurricular activities (also pretty difficult if they are going to get into top colleges).

@Dave: good for you that you can eat healthy on $4.50 a day. The budget for the woman in the article is $2.38 per day per person.
@Johann: $2.38 per person. You spend $2 on lettuce for the day, you’re going to be pretty hungry.
I read one heartbreaking quote of a disabled mother with a 12-year-old daughter. She gives the food to her daughter, because she can stand the hunger, but the kid can’t. That’s not famine-era Ireland, that’s 21st century America.
And to those who say these people should get a job, a lot of them have jobs. Or two or three. WalMart costs the taxpayers millions of dollars by refusing to pay their workers enough to live on.
The House of Representatives decided to keep farm subsidies,which many members of Congress, including my local rep, Vicki Hartzler, enjoy to the tune of hundreds of thousands of dollars, while cutting food stamps. The system is rigged so we keep giving more and more money to Vicki, and the WalMart heirs,and tolerating hunger in innocent children among us. I dream of an America where everyone gets enough to eat, and can go to the doctor when they’re sick. Crazy, right?

My understanding is that many people who receive food stamps also receive other types of aid that can be used for food. Aside from free or reduced lunches at school, I can’t remember any of the other sources of $ for food. Do any of you know? I could always try to do a search for this information.

Like so many other policy-related issues, we don’t have full information about the true nature of the problem. It is difficult to craft good solutions to problems when facts related to them are incomplete or unclear.

“WalMart costs the taxpayers millions of dollars by refusing to pay their workers enough to live on.

Does WalMart not pay its corporate employees well or its cashiers or people who work on the floors of their stores? I really don’t know the answer to this, but I’ve heard this charge leveled against WalMart often. Aren’t most jobs in stores only worth about minimum wage?

It really shouldn’t be that expensive to hire some dietitians to put together some healthy meals that are affordable on food stamps.

Regardless of expense, it’s a ridiculous notion that people will not learn how to cook without the government showing them.

And there are probably numerous resources available already to the population of food stamp nation.

And I agree with you on limiting foods that qualify for food stamps. Heck, I’d eliminate the middle man and give them a fixed amount of food per person per week. That’s what most food banks and church pantries do.

The children (or at least the 9-year-old, maybe also the 4-year-old) of the family featured in the article Rod referenced probably qualify for free or reduced lunches, so the family does not need to use food stamp money for them.

“Honey, eat a big free lunch at school so I don’t have to feed you supper.”

“Last year’s campaign season taught us that we are endowed by our Creator with certain unalienable rights, among those are the unlimited consumption of seven eleven big gulp cokes. Seriously, that’s the hill that the tea party is going to die on?”

Gee, I thought the lesson was how great and powerful Latinos are, and how this young and dynamic workforce is going to save greying, formerly mostly white America.

“OK, I’ll say it: you can get a lot more food for your family if your family doesn’t have five kids.”

Sweet. I totally agree. So you support the notion that birth control and reproductive health services need to be available and affordable for lower in come women? After all, it’s cheaper to pay for some birth control for a woman on welfare than to pay for a child.

“I dream of an America where everyone gets enough to eat, and can go to the doctor when they’re sick. Crazy, right?”

Right, for what should be a fairly obvious reason. Let’s say Walmart (which I’m not a huge fan of, mind you) does pay its employees a “living wage”. Who’s to say they still won’t just piss it away? The assumption that everything would be peachy keen if only people had equal amounts of money, employment, insurance, etc. is what needs to be questioned.

Its human nature-not everyone has the intellect or common sense to make good choices. Certainly you’ve read about folks who end up in the poor house after winning a large lottery jackpot-chalk it up to poor decision making. If we’d take everyone’s money and goods and put it in a pot, the redistribute it equally, or even more towards the folks that were “disadvantaged”, before long things would work themselves back to a pyramid structure. That’s the way people are, they do not magically get smarter once they have more money or material advantage. There would be some crossing of economic lines, certainly, but we’d be right back to a teaming mass of poor and a pinnacle of rich.

“Talking Points Memo had a great article from a person who grew up poor on why the poor make some choices that don’t make sense to those of us from more privileged backgrounds”

Hell, I’ve done that. You’d be suprised what a jacket and tie can do for a 18 year old punk kid. People live up a notch/dress to impress/do a little etiquette research if they are smart, like the author of that article’s relatives. Folks who have that good sense tend not to stay poor.

However, that’s not the way that necessarily materializes. A rusty/beat up Caddy, a Louis Vutton hand bag, a smartphone with a doo-dadded up case, coupled with sweats and a poor handle on the English language do not have that same effect. But, that is more along the lines of what I see. Those are the kind of choices that are subject to criticism. A Caddy might give you an aire of respectability, but not if its obviously seen better days. Plus, whether a looker or a junker, wait until something goes or wears out and you get the repair bill. Yikes.

The bag and the phone can’t fix the rest of the ensemble or the behavior of the wearer. No, there are plenty of examples of poor people blowing their money on material crap that is detrimental to their well being based on internal cultural “expectations”. Its also a matter of priorities.

In my area, if one drives up to the “ghetto”, you’ll see quite a few Caddies, Lincolns, Chrysler 300s, Buick Lucernes and other luxury or midrange “almost luxury” cars parked along side or on the street in front of what looks like a dilapidated dump. Its priorities. Now, of course, its not my business if someone would rather have a sweet ride over a nice house. Thats fine and dandy. But say that is your priority. Where’s the garage for your investment? Why are you parking it in a crap neighborhood like this? There goes the hood ornament, the stereo, a rim or two (or four…) and then before long its on blocks. Wither your sweet ride?

Does the government give food stamp recipients menu samples of low-cost, healthy, easy to prepare, and affordable meals that are also easy to read (meaning something like it doesn’t look like the literature that accompanies medicines)?

WIC does this. I don’t know whether the handouts are actually used, but in order to receive WIC you must attend nutrition classes which focus on ideas for using WIC-approved foodstuffs. Cooked beans last a long time in the fridge, and there are many, many ways to prepare them.

But then, one of the women in the article didn’t have a refrigerator.

And the main subject of the article couldn’t get her children to eat the expensive, nutritious pre-packaged lunches she sent to school with them; nor get them to wait long enough for her to cook something.

“The children (or at least the 9-year-old, maybe also the 4-year-od) of the family featured in the article Rod referenced probably qualify for free or reduced lunches, so the family does not need to use food stamp money for them.”

“I do believe that was in response to Mayor Bloomberg’s little attempt to outlaw such things in New York to cash paying customers. Its one thing to make poor beverage choices on your own dime, its another to make them on ours.”

“Regardless of expense, it’s a ridiculous notion that people will not learn how to cook without the government showing them.

And there are probably numerous resources available already to the population of food stamp nation.”

There may very well already be good resources for food stamp recipients. But if there aren’t, it might make sense to provide them with easy meal ideas since so many food stamp recipients are apparently eating very badly and making themselves and their families unhealthy.

Many of these women are too exhausted from working several jobs to learn how to cook in a more healthy way, or to coax a reluctant child to eat what is not immediately appealing. What’s needed in these households is a father with a job with a living wage so that the mother does not have to kill herself working at Wal-Mart. Genetics may play a big role in obesity, but I think fatherlessness might play an even bigger one.

Using your numbers and comparing apples to apples (or chicken to vegetables and chicken to vegetables), the healthier meal is $3.44 compared to $3.57 for the TV dinners. Add the potatoes to the healthier meal and maybe the healthier meal is a few cents over for quite a bit more food. But thank you for evidencing that healthier food can be purchased on a budget.

“Of course, when the providers of such food take our dime in doing so, that’s OK…right?”

That is besides the point, and you know it.

However, to that point, that’s a problem with the tax code-isn’t it? You can hardly blame a corporation (and it was more than food companies) for doing something legal. Also, how is “lost” tax revenues “our dime”, praytell?

Make no mistake, whether Washington got every penny of taxes they could get from big corporations or not, they’d end up wasting it anyway.

This group, which has chapters in Idaho and Illinois so far along with some national efforts, does the things poor families actually need: offering classes in food and nutrition and healthy cooking, and in some cases offering help in the form of appliances like rice cookers and slow cookers/crockpots which can be used to prepare healthy meals inexpensively (and in the case of slow cookers, there is the added advantage that dinner is *ready* when the family comes home from work and school, which is important).

I found this group when I got into an argument at another blog about whether providing the poor with slow cookers would be a good way to start addressing some of these issues. People were awfully dismissive, saying that “anybody” can afford $20 to $30 for a decent-sized slow cooker, and if the poor choose not to buy these items it’s just proof that they are too lazy and too addicted to junk food to change.

I love the “Nurture” program because it shows how untrue those assumptions are. I also learned, in doing a bit more research, that in point of fact many poor families live in places where the landlord-provided cooking equipment is substandard: a cheap microwave, a stove with maybe one working burner, that sort of thing. A slow cooker can be a godsend for some of these families, especially if someone takes the relatively small amount of time necessary to show the family how to use it to stretch the food dollar.

Among Stephanie O’Dea’s many recipes there are plenty which use inexpensive ingredients and/or make quantities which will last for several meals for a smaller family. If you really want to help a poor family in your area, perhaps a copy of O’Dea’s cookbook (or any slow cooker cookbook, really!) along with a slow cooker would be a donation worth making.

The thing I find most disturbing is that many people seem to want to believe that poverty and obesity are the result of character deficiencies, which frees us from any obligations to the poor. In the vast majority of cases, nothing could be further from the truth.

Obviously none of the “just buy and cook some rolled oats” crowd has never experienced genuine poverty.

The photo gallery which goes with the article shows people who live in trailers with no windows. No refrigerators. No government water (where are they getting their water from? It doesn’t say.) Fast food restaurants, but what kind of grocery stores? Probably none, only small convenience stores that may have a cooler only big enough for milk and a few cold snacks, but plenty of room for soda and beer.

What’s not said here is that nobody in this desperately poor county is going to garden, or travel 25 miles round-trip to shop at a Wal-Mart, even. The people with no fridges cannot buy produce, period – or fresh milk for that matter.

In other words, you’re talking about living in third-world conditions WITHOUT the third-world support networks and infrastructure that makes that level of poverty bearable. Let’s enumerate:

1. having your children working on the street selling trinkets or begging, rather than going to school (which requires school clothes, supplies, etc.)

2. Having souks or open-air markets within walking distance, where at least a day’s worth of fresh food can be bought one day at a time.

3. Being in a dense urban center like Bangalore or Mumbai, where there is very low cost public transit and close-knit social structures, as well as opportunity for sporadic cash economy work on a day-labor basis.

In short, the people who live in McAllen, TX, find themselves in the worst of both worlds.

A final note about food stamps. I used to work up a big indignation fest about the “bad food” bought on food stamps. No more. A few dollars buys a full day’s calories. Restricting purchases will not make the recipients “healthier.” It will result in the local stores dropping food stamps, because they will not be able to afford to expand their inventories (especially because of the regulations surrounding the sale of cold food like dairy and meat.) Or they’ll just go out of business.

Then what are the people in these literal ecological and food deserts supposed to eat? Then you may see the morally and aesthetically-approved kinds of starvation, with all the signs of kwashiorkor. But at least they won’t be fat.

“Honey, eat a big free lunch at school so I don’t have to feed you supper.”

I’m not really sure what you mean by your comment. However, I just re-read my comment, and it sounded a bit like I was saying the family doesn’t need to use any food stamp money for the kids, but I intended to say they don’t need to use food stamp money for the kids’ lunches. Therefore, the family would have a little more than $1.50/meal to allocate for each of their other meals.

@Gretchen, I was referencing the number in the article for the “standard government allotment” where it said she gets 1.50/ meal. I assumed this was your standard 3 meal breakfast, lunch, dinner set up the government usually does. If that’s the case she gets 3 x 1.50 or 4.50/ day. More than enough to eat nutritiously if you desire.

@Richard, using your own example of a TV dinner vs home made dinner from the components, it is still cheaper to eat the home made if you’re not eating more in the home made (as you had in your example). It may take a bit more time to prepare the fresh meal, but it’s not more expensive to buy the ingredients (also assuming reasonable portion sizes) and it has the added benefit of being the better option.

@Gretchen, also I believe I said mine was significantly cheaper than 4.50/day. I think it was closer to 3-3.10/day but I could also cut that down by buying slightly less nutritious ingredients (still a lot better than your standard packaged dinners). I don’t do this because I don’t have to, but it is possible.

“Using your numbers and comparing apples to apples (or chicken to vegetables and chicken to vegetables), the healthier meal is $3.44 compared to $3.57 for the TV dinners.”

Indeed…until you take into count the cost of the family’s time in meal prep. I’m guessing that the mother may well be working a couple of part time jobs to make ends meet, and still has to take care of the house. Given the savings under my scenario is 13 cents per meal, which one do you think she has more time and energy to fix in the midst of doing laundry, helping kids with school work, and getting them ready for bed?

You see…adding in the cost of the potatoes might well make the meals cost the same. But then they have to be peeled, cooked and mashed. I know that conservatives don’t apply any cost to “women’s work” but a single mom probably recognizes the opportunity cost of such things.

Thank you for demonstrating the flaw in conservative reasoning about the cost of food in a poor home.

>The Bible also says that if you don’t work, you don’t eat. In the new testament, charity was reserved for widows and orphans.

Josh, the matter is adequately covered in the Catechism. You don’t get to raise objections.
Submission of both Will and Intellect.
Those questions you raise fall under Apostolic ministry, and not under individual decision.

>And furthermore, charity is something one freely gives to another. Not something taken by government force and given to another.

It is not yours nor mine to question the decisions of Governmnt in the first place.

Whatever concerns you may have about who gets it has no bearings on who gives it.

“We have almost fifty years of data showing that government anti-poverty programs have not reduced poverty.”

Actually, we have more than fifty years of data, going back to before the Lyndon Johnson administration and his war on poverty. People would be wise to consult it, since they’re on the hook for their share of Census statisticians’ pay anyway.

“Indeed…until you take into count the cost of the family’s time in meal prep. I’m guessing that the mother may well be working a couple of part time jobs to make ends meet, and still has to take care of the house.”

Did you people actually read the article. She’s a mother of five on disability on 40. Had her first kid at 19, by a man who ‘dissappeared into Mexico’. She should have stopped then. She went on to have five.

We should not in anyway be subsidizing this woman and her irresponsible child bearing. Not ‘free’ school lunches, not SNAP/EBT, not section 8. Nothing.

It would be helpful to have more facts regarding people who receive food stamps. For instance,

1.) How many receive food stamps for a relatively short period of time and how many receive them chronically?

2.)How many of the people living in the horrible living conditions that Stef described are in the United States illegally? My understanding is that very few U.S. citizens live in these types of conditions, although I could be completely wrong about this.

3.) How much money per day do people get from food stamps (I think this varies by income)?

4.) Typically how many other sources of food or money for food do low-income people receive (i.e., food banks, WIC, reduced or free lunches at school) and how much does this actually add up to per person per meal?

I’m sure there are many other facts that would be useful to know. Without having objective, non-partisan facts to the questions above that both sides can agree upon, we mostly have a bunch of opinions based on entirely different sets of assumptions.

“In other words, you’re talking about living in third-world conditions WITHOUT the third-world support networks and infrastructure that makes that level of poverty bearable. Let’s enumerate:”

Which is exactly why we should stop further Mexican immigration — legal and illegal. They are better off on the other side of the border, and they don’t turn great swathes of our country into a place worse than Mexico.